1. 22nd March 2017 Dr Simon Willson
Right Time…Right Place…Right Conversation: Improving the Relationship between Essex Care Providers and Essex County Council
22nd March 2017
Dr Simon Willson

2. Structure for Today Background to Essex Why and How We Did the Review
Findings
Reflections 2

3. Part 1: Brief Background to Essex

4. The market in numbers…
Residential: 464 services registered as care homes in Essex (excluding Southend and Thurrock) providing 12,977 beds
15 homes (12%) on the framework are not honouring their prices
390 providers of domiciliary care to ECC
60% of current placements are made using spot arrangements.
400+ placements in the last year have taken considerable time to source via the Unmet needs process.
40% of unmet needs packages are as a result of capacity issues within the market
32% of unmet needs packages are as a result of location
1 in 4 vacancies/79 registered manager vacancies

5. The market in numbers… 17,000 service users
In ten years the OP population is expected to grow by 24.67%, while the whole population is only expected to grow by 8.9%
2016/17 £45m gap. £60m gap in 2017/18 (£400m spend overall)
79% providers rated good or above by CQC (regional leaders/2nd in nearest and dearest)
National Patient Strategy Award winner for Prosper

6. The market in words
ECC adopts a traditional approach to the market, this includes standard framework and spot contracts
Commercially led
An agreed quality and improvement strategy to raise standards in the market
An emerging workforce strategy - Essex Skills Board
Undertaken a cost of care exercise with the market to understand true costs
Integration is slow
Market does not represent itself well

7. Part 2: The Why and How

8. Why A Perception that Relationships Were Getting Worse
The Care Act and Shaping the Market 
Pressures
Quality Improvement Work

9. Project Aims Understand why relationships had worsened
Understand how both parties perceived each other
Assess the appetite for working together in the future
Clarify what people thought must change to make them feel the project had been successful (what became known as the ‘Must Haves’)
Identify areas for improvement
Suggest how these improvements might be made.

10. Methodology
A written questionnaire completed by officers and care providers
7 workshops sessions (5 with officers and 2 with providers)
A benchmarking survey completed by 6 local authorities in the East of England
Telephone discussions with some of ECC’s larger care providers
Discussions with other local authorities
Discussions with national provider organisations UK Home Care Association (UKHCA) and Registered Nursing Home Association (RNHA) and with local authority based care provider organisations in Devon, Hertfordshire, Norfolk and Surrey.

11. Methodology
Published report for feedback (not consultation) whole market
Agreed with directors and briefed lead cabinet and published and then into ‘governance’
CEO interest
Importance of independence - me and Colin and Ian
Some big providers missing
Kept away from ECC project and governance

12. Part 3: Findings

13. Headlines 4 ‘Themes’ 7 AFIs
29 individual recommendations (suggested solutions for many)

14. 4 ‘Themes’ Areas Trust and Partnering Leadership Engagement
Operational

15. 7 AFIs

16. Current Progress ECA created (considering funding)
29 Nov and 26 April ‘strategic’ event
Shadow strategic group to support market shaping strategy work
Clarifying roles as part of restructuring
Proposed ‘market relations team’ within in a full commissioning function in Adults

17. Part 3: Reflections

18. Leadership Who leads – from both sides? Do they have the:
Will/appetite?
Skills?
Time?
It takes time
Providers value organ grinders not monkeys
Keep a high profile as officer lead
Leadership of ‘hope’

19. Engagement – who, what and how?
What is meant by this – the ladder of participation?
Roles and responsibilities – who does what and do they have the right skills?
Who do you need to talk to, what about and how often?

20. Partnering What is meant by this?
Who needs to partner with whom and why?
How does partnering actually work and how is it assessed?
The importance of trust and honesty
Understanding - different perspectives and needs
Dialogue
Valuing each other

21. Last Thoughts Its not rocket science, but….
Hard environment to build positive relationships - what is the alternative?
Requires effort – appetite, ambition, desire
Needs to give both sides what they need, as well as the mutual gains?
Different motivations from the market: some just commercial others more vocational – needs sophistication. But, there are businesses
Providers want to be valued - frightening world out there: CQC, money reducing, attracting staff. They are human.
Respected as an equal partner not a ‘poor relation’
…. And one more thing

22. If nothing else….stick to the knitting!